Cost-related issues are often connected to ethical dimensions of health care policy and practice. As Betty Rambur, professor of nursing at UVM puts it, "Nurses go beyond the biomedical. We're holistic in our approach. That impacts the ethics of health economics. It's opened the door to exciting models that include thinking about broader systems of care."
Another challenge with ethical implications is keeping up with necessary technology while not losing sight of important interpersonal contact and communication. "The advent of the computer has helped in many ways," says Felicia Robinson, a labor and delivery nurse at Brattleboro Memorial Hospital's birthing center. "It's easier to assess someone's medical record or to see labs. But the computer can be a barrier between the clinician and the patient. I review the medical record before entering the room. I sit facing the patient and make eye contact. When I turn to the computer I read her what I've written. So my patient is involved in the process. She feels confident I have 'heard' her."
Ever evolving policies, practice norms and financing mechanisms coupled with institutional systems changes mean new opportunities as well as challenges for the country's nearly 3 million registered nurses. Clearly it's an awesome time to be a nurse.
Excerpted from an article that appeared in Vermont Woman, April/May, 2015. Cross posted with Daily Kos.
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